[en] Purpose. Firstly, to examine whether heart rate (HR) can be predicted based on the Borg-scale for perceived exertion in patients with chronic low back pain (CLBP) and secondly, to assess changes in HR, Borg-scores and workload to study the relevance of a stepwise increase of workload based on the Borg-score and HR. Methods. Ninety-nine patients with CLBP and a mean disability-score (Roland Morris Disability Questionnaire) of 13.8 (SD = 3.7) participated in a 10-week aerobic training programme (20 min, 3 times/week). HR, ratings of perceived exertion (RPE), and workload were monitored. Prior to treatment, patients completed questionnaires on pain, disability, and several psychological factors (catastrophizing, kinesiophobia, and depression). Results. The original Borg-equation (i.e. 'HR = Borg x 10') appears accurate in predicting HR on a group-level. Pain-related and psychological factors were not significantly related to the accuracy of the Borg equation. Whereas mean workload increased significantly (from 93.8 (SD = 29.9) to 129.5 W (SD = 39.7), p < 0.001) throughout the training programme, HR increased only slightly (from 130.2 (SD = 13.5) to 139.2 (SD = 13.9) bpm; p < 0.001) and Borg-scores remained stable (from 13.2 (SD = 1.9) to 13.3 (SD = 1.8); p = 0.48). Conclusions. The capability of the Borg-scale to accurately predict HR appears moderate. However combined with measuring HR, it results in a relevant and efficient method for training CLBP patients in clinical practice.
Disciplines :
Orthopedics, rehabilitation & sports medicine
Author, co-author :
Demoulin, Christophe ; Université de Liège - ULiège > Département des sciences de la motricité > Kinésithérapie spécifique et réadaptation motrice
Verbunt, Jeanine A; CAPHRI - Maastricht University
Winkens, Bjorn; Universiteit Maastricht > Methodology and Statistics
Knottnerus, J Andre; CAPHRI
Smeets, Rob J; CAPHRI - Maastricht University
Language :
English
Title :
Usefulness of perceived level of exertion in patients with chronic low back pain attending a physical training programme.
Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber- Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006;15(Suppl 2):S192-S300.
Protas E. Aerobic exercise in the rehabilitation of individuals with chronic low back pain: a review. Crit Rev Phys Rehabil Med 1996;8:283-295.
Gretebeck RJ, Montoye HJ, Ballor D, Montoye AP. Comment on heart rate recording in field studies. J Sports Med Phys Fitness 1991;31:629-631.
Borg E, Kaijser L. A comparison between three rating scales for perceived exertion and two different work tests. Scand J Med Sci Sports 2006;16:57-69.
Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 1970;2:92-98.
Chen MJ, Fan X, Moe ST. Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: a meta-analysis. J Sports Sci 2002;20:873-899.
Borg G, Hassmen P, Lagerstrom M. Perceived exertion related to heart rate and blood lactate during arm and leg exercise. Eur J Appl Physiol Occup Physiol 1987;56:679-685.
Zeni AI, Hoffman MD, Clifford PS. Relationships among heart rate, lactate concentration, and perceived effort for different types of rhythmic exercise in women. Arch Phys Med Rehabil 1996;77:237-241.
Hall EE, Ekkekakis P, Petruzzello SJ. Is the relationship of RPE to psychological factors intensity-dependent? Med Sci Sports Exerc 2005;37:1365-1373.
Morgan WP. Psychological components of effort sense. Med Sci Sports Exerc 1994;26:1071-1077.
Dunbar CC, Robertson RJ, Baun R, Blandin MF, Metz K, Burdett R, Goss FL. The validity of regulating exercise intensity by ratings of perceived exertion. Med Sci Sports Exerc 1992;24:94-99.
Weiser PC, Wojciechowicz V, Funck A, Robertson RJ. Perceived effort step-up procedure for self-regulating stationary cycle exercise intensity by patients with cardiovascular disease. Percept Mot Skills 2007;104:236-253.
Garcin M, Wolff M, Bejma T. Reliability of rating scales of perceived exertion and heart rate during progressive and maximal constant load exercises till exhaustion in physical education students. Int J Sports Med 2003;24:285-290.
Ozkan A, Kin-Isler A. The reliability and validity of regulating exercise intensity by ratings of perceived exertion in step dance sessions. J Strength Cond Res 2007;21:296-300.
Eston RG, Davies BL, Williams JG. Use of perceived effort ratings to control exercise intensity in young healthy adults. Eur J Appl Physiol Occup Physiol 1987;56:222-224.
Glass SC, Knowlton RG, Becque MD. Accuracy of RPE from graded exercise to establish exercise training intensity. Med Sci Sports Exerc 1992;24:1303-1307.
Kang J, Chaloupka EC, Mastrangelo MA, Donnelly MS, Martz WP, Robertson RJ. Regulating exercise intensity using ratings of perceived exertion during arm and leg ergometry. Eur J Appl Physiol Occup Physiol 1998;78:241-246.
Marriott HE, Lamb KL. The use of ratings of perceived exertion for regulating exercise levels in rowing ergometry. Eur J Appl Physiol Occup Physiol 1996;72:267-271.
ACSM. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc 1990; 22:265-274.
Dishman RK. Prescribing exercise intensity for healthy adults using perceived exertion. Med Sci Sports Exerc 1994;26: 1087-1094.
Klaber Moffett J, Frost H. The Back to fitness programme: the manual for physiotherapists setting up exercise classes. Physiotherapy 2000;86:295-305.
Dawes HN, Barker KL, Cockburn J, Roach N, Scott O, Wade D. Borg's rating of perceived exertion scales: do the verbal anchors mean the same for different clinical groups? Arch Phys Med Rehabil 2005;86:912-916.
Borg GA. Perceived exertion: a note on "history"and methods. Med Sci Sports 1973;5:90-93.
Barker KL, Dawes H, Hansford P, Shamley D. Perceived and measured levels of exertion of patients with chronic back pain exercising in a hydrotherapy pool. Arch Phys Med Rehabil 2003;84:1319-1323.
Wallbom AS, Geisser ME, Haig AJ, Yamakawa K, Montgomery D. Concordance between rating of perceived exertion and function in persons with chronic, disabling back pain. J Occup Rehabil 2002;12:93-98.
Smeets RJ, Vlaeyen JW, Hidding A, Kester AD, van der Heijden GJ, van Geel AC, Knottnerus JA. Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]. BMC Musculoskelet Disord 2006;7:5.
Bolton JE. Accuracy of recall of usual pain intensity in back pain patients. Pain 1999;83:533-539.
Huskisson EC. Measurement of pain. Lancet 1974;2:1127-1131.
Gommans H, Koes B, Van Tulder M. Validiteit en responsiviteit: Nederlandstalige Roland Disability Questionnaire. Ned T Fys 1997;2:28-33.
Roland M, Morris R. A study of the natural history of back pain. Part I: Development of a reliable and sensitive measure of disability in low-back pain. Spine 1983;8:141-144.
Sullivan M, Bishop S, Pivik J. The pain catastrophising scale: development and validation. Psychol Assess 1995;7:524-532.
Van Damme S, Crombez G, Bijttebier P, Goubert L, Van Houdenhove B. A confirmatory factor analysis of the pain catastrophizing scale: invariant factor structure across clinical and non-clinical populations. Pain 2002;96:319-324.
Goubert L, Crombez G, Vlaeyen J, Van Damme S, Van den Broeck A, Van Houdenhove B. De Tampa schaal voor Kinesiofobie: psychometrische karakteristieken en normering. Gedrag en Gezondheid 2000;28:54-62.
Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 1995;62:363-372.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571.
Van der Does AJW. BDI-II-NL handleiding: De nederlandse versie van de beck depression inventory. 2nd ed., Dutch BDIII Manual. Amsterdam, Harcourt; 2002.
Hodselmans AP, Dijkstra PU, Geertzen JH, van der Schans CP. Exercise capacity in non-specific chronic low back pain patients: a lean body mass-based astrand bicycle test; reliability, validity and feasibility. J Occup Rehabil 2008;18: 282-289.
Vos J. Ergometrie en trainingsbegeleiding. Amersfoort, The Netherlands: Nederlands Paramedisch Instituut; 2004.
ACSM. ACSM position stand on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in adults. Med Sci Sports Exerc 1998;30:975-991.
Karvonen M, Kentala K, Mustala O. The effects of training heart rate: a longitudinal study. Ann Med Exp Biol Fenn 1957;35:307-315.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-310.
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14:377-381.
Capodaglio P. The use of subjective rating of exertion in Ergonomics. G Ital Med Lav Ergon 2002;24:84-89.
Garcin M, Vautier JF, Vandewalle H, Monod H. Ratings of perceived exertion (RPE) as an index of aerobic endurance during local and general exercises. Ergonomics 1998;41: 1105-1114.
O'Neill ME, Cooper KA, Mills CM, Boyce ES, Hunyor SN. Accuracy of Borg's ratings of perceived exertion in the prediction of heart rates during pregnancy. Br J Sports Med 1992;26:121-124.
Whaley MH, Brubaker PH, Kaminsky LA, Miller CR. Validity of rating of perceived exertion during graded exercise testing in apparently healthy adults and cardiac patients. J Cardiopulm Rehabil 1997;17:261-267.
Doherty M, Smith PM, Hughes MG, Collins D. Rating of perceived exertion during high-intensity treadmill running. Med Sci Sports Exerc 2001;33:1953-1958.
Morgan WP. Psychological factors influencing perceived exertion. Med Sci Sports 1973;5:97-103.
Pincus T, Vlaeyen JW, Kendall NA, Von Korff MR, Kalauokalani DA, Reis S. Cognitive-behavioral therapy and psychosocial factors in low back pain: directions for the future. Spine 2002;27:E133-E138.
Hill DW, Cureton KJ, Grisham SC, Collins MA. Effect of training on the rating of perceived exertion at the ventilatory threshold. Eur J Appl Physiol Occup Physiol 1987;56:206-211.
Wennemer HK, Borg-Stein J, Gomba L, Delaney B, Rothmund A, Barlow D, Breeze G, Thompson A. Functionally oriented rehabilitation program for patients with fibromyalgia: preliminary results. Am J Phys Med Rehabil 2006;85: 659-666.
Kilpatrick MW, Kraemer RR, Quigley EJ, Mearsi JL, Powers JM, Dedea AJ, Ferrer NF. Heart rate and metabolic responses to moderate-intensity aerobic exercise: a comparison of graded walking and ungraded jogging at a constant perceived exertion. J Sports Med 2009;27:509-516.
Siegel D, Johnson J. A preliminary study of pacing in cycling. JSB 1992;15:75-86.
